Medical guidewire

Abstract

A guidewire system may include a guidewire having a relatively stiff proximal section and a relatively flexible distal section joined by a transition region, and a TAVI device slidably disposed on the guidewire. The guidewire may include an expandable element disposed about the transition region. The expandable element may be configured to expand from a collapsed configuration to an expanded configuration. The guidewire may include an expandable element disposed at the distal end. The distal section may be pre-configured to form more than one distal loop. A method of protecting an apex of a left ventricle during a TAVI procedure may include inserting a guidewire into the left ventricle, positioning a transition region adjacent the apex, expanding an expandable element such that the expandable element spans the apex, advancing a TAVI device distally over the guidewire to an aortic valve, and performing a TAVI procedure at the aortic valve.

We claim: 
     
         1 . A guidewire system, comprising:
 a guidewire having a proximal end, a distal end, and a length extending therebetween;   wherein the guidewire includes a relatively stiff proximal section and a relatively flexible distal section joined by a transition region; and   a TAVI device slidably disposed on the guidewire;   wherein the guidewire includes an expandable element disposed about the transition region in a first position;   wherein the expandable element is configured to expand from a collapsed configuration to an expanded configuration.   
     
     
         2 . The guidewire system of  claim 1 , wherein the expandable element includes an inflatable balloon. 
     
     
         3 . The guidewire system of  claim 2 , wherein the guidewire includes a lumen extending through the proximal section to an inflation port opening into the inflatable balloon. 
     
     
         4 . The guidewire system of  claim 2 , wherein the inflatable balloon includes a generally wide, flat cross-section. 
     
     
         5 . The guidewire system of  claim 4 , wherein the inflatable balloon includes a thin middle section extending longitudinally along a length of the inflatable balloon. 
     
     
         6 . The guidewire system of  claim 2 , wherein the inflatable balloon is fixedly attached to the guidewire. 
     
     
         7 . The guidewire system of  claim 2 , wherein the inflatable balloon is slidably attached to the guidewire. 
     
     
         8 . The guidewire system of  claim 7 , wherein the guidewire includes a distal stop fixed to the distal section. 
     
     
         9 . The guidewire system of  claim 8 , wherein the distal stop is configured to arrest distal translation of the inflatable balloon along the guidewire at a second position. 
     
     
         10 . The guidewire system of  claim 1 , wherein the expandable element includes an expandable foam. 
     
     
         11 . The guidewire system of  claim 1 , wherein the expandable element includes a self-expanding frame. 
     
     
         12 . The guidewire system of  claim 11 , wherein the self-expanding frame is configured to collapse as the TAVI device is advanced distally over the self-expanding frame. 
     
     
         13 . The guidewire system of  claim 1 , wherein the distal section is pre-shaped to form a distal loop. 
     
     
         14 . A guidewire system, comprising:
 a guidewire having a proximal end, a distal end, and a length extending therebetween;   wherein the guidewire includes a relatively stiff proximal section and a relatively flexible distal section joined by a transition region; and   a TAVI device slidably disposed on the guidewire;   wherein the guidewire includes an expandable element disposed at the distal end.   
     
     
         15 . The guidewire system of  claim 14 , wherein the expandable element is an inflatable balloon. 
     
     
         16 . The guidewire system of  claim 15 , wherein the guidewire includes an inflation lumen extending therethrough. 
     
     
         17 . The guidewire system of  claim 14 , wherein the distal section is pre-shaped to form a distal loop. 
     
     
         18 . A guidewire system, comprising:
 a guidewire having a proximal end, a distal end, and a length extending therebetween;   wherein the guidewire includes a relatively stiff proximal section and a relatively flexible distal section joined by a transition region; and   a TAVI device slidably disposed on the guidewire;   wherein the distal section is pre-configured to form more than one distal loop.   
     
     
         19 . The guidewire system of  claim 14 , wherein a distalmost loop is larger than a more proximal loop. 
     
     
         20 . A method of protecting an apex of a left ventricle of a heart of a patient during a TAVI procedure, the method comprising:
 inserting a guidewire upstream through an aorta of the patient and into the left ventricle, the guidewire including a relatively stiff proximal section, a relatively flexible distal section joined to the proximal section by a transition region, and an expandable element disposed about the transition region;   positioning the transition region adjacent the apex;   expanding the expandable element from a collapsed configuration to an expanded configuration within the left ventricle such that the expandable element spans the apex;   advancing a TAVI device distally over the guidewire to an aortic valve; and   performing a TAVI procedure at the aortic valve.